Atypical fracture of the femur in a patient using denosumab – a case report

A woman born in 1930 was diagnosed with osteoporosis in 2000, and was started on treatment with alendronate. Her lumbar T-score in 2010 was –3.0. In 2008, she had a displaced atypical fracture of her left femur, which healed uneventfully after intramedullary nailing (Figure 1). No radiographs of her contralateral femur were obtained. She continued taking alendronate until it was stopped in September 2010. In February 2011, she received a single zoledronate infusion. No bisphosphonate was given after that, due to reduced kidney function. She received a first injection of denosumab in April 2012 and then every 6 months, with the last and fourth injection in October 2013.